| NPI | 1750755294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMON RASKIN President 310-459-4333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA G0813334) |
| Enumeration Date | 2015-11-20 |
| Last Update Date | 2015-11-20 |